By the time diabetes is diagnosed, in general, body cells are saturated with glucose, excess glucose is being stored as fat in the liver causing fatty liver disease, excess fat is being stored in the pancreas impairing insulin production, whilst in the background insulin has been running at high levels for around a decade causing hyperinsulinemia which has promoted fat storage and weight gain. Blood glucose levels will be running higher than normal, increasing the risk of diabetes related complications.

For many at this point the biggest goal is either to prevent starting medication in the first place, to halt the spiral of having to take ever increasing medication doses (which often have side effects) or are keen to avoid the initiation of insulin injections. This is where the power of dietary changes can really make a difference.

As a snap shot of the way nutrition can address diet or medication controlled type 2 diabetes and potentially put it into remission I would say the four main areas are lower refined carbohydrate diets, fasting, weight loss and gut bacteria.

Controlling refined carbohydrates limits glucose entering the bloodstream giving respite to overfilled body cells and promotes the use of stored glucose, fasting allows us to use our fat stored in the organs as well as under the skin, weight loss itself reduces pancreatic fat allowing the pancreas to resume normal functionality and boosting beneficial gut bacteria aids glucose control.

Depending on you, your lifestyle, your likes and dislikes and your motivation we can work with anywhere from one to all four of these areas to develop a holistic plan fitting your personal circumstances.  As with anything worth doing right there are no quick fixes but with my knowledge, experience (both clinical and personal), resources and support I am confident that as a diabetes nutritionist and dietitian I can support you in achieving your goals for long term health and diabetes control or remission.

Unfortunately it is thought that around 40 factors affect blood glucose levels, making them relatively unpredictable, even when using some of the latest glucose monitoring technology. However I really enjoy helping people better understand and balance their insulin to their carbohydrate – something called a carbohydrate to insulin ratio. For those not trained in ratios, it can be life changing – by balancing carbohydrates with insulin allows huge flexibility to eat what you want, when you want and match your insulin to it, rather than just eating to ‘feed’ the insulin.

For some, another game changer can be the use of moderate or lower carbohydrate diets as lower carbohydrate intakes results in less of a glucose spike (glucose variability) as well as smaller insulin doses which then behave more predictably and also helps with weight loss if this is a concern.

I can also support you in checking your basal (background) insulin dose (if this is wrong diabetes will always be less predictable), glycaemic index to manage glucose fluctuations and I have undertaken enhanced training on managing blood glucose levels during exercise in type 1 diabetes.

If you would like support in understanding and implementing carbohydrate to insulin ratios, or want help checking your current ratios or any of the techniques to improve glucose control from a diabetes specialist nutritionist and dietitian then please get in touch.

Having personally been diagnosed with PCOS in 2013, PCOS is a condition close to my heart. It comes in two forms – what I would call ‘healthy weight PCOS’ which mainly affects fertility and ‘higher weight PCOS’ which can be a devastating condition affecting women in numerous ways –irregular periods,  infertility, weight gain, excess hair, poor skin, cravings and so on. At the heart of it PCOS is a condition of insulin resistance – addressing this is the key to managing the condition. Lower carbohydrate intakes, lower glycaemic index food choices, or a combination both is the backbone of PCOS advice and I hugely enjoy working with women in a way that supports them to make changes acceptable to them and their lifestyle to hopefully see life changing benefits.

Weight loss injections are a game changer for many people. Literally freeing them from the noise of food that usually surrounds them all day, or constant hunger that is never truly satisfied. However these medications have their side effects!

With my experience of working with clients since these medications first came out, as well as whilst running clinical trials on them I have a good knowledge of how to use these medications effectively.

Common side effects include nausea, vomiting, bloating, constipation and so on, which often can be addressed with food choices, portion sizes and dietary tweaks.

Muscle loss on any diet is a concerning factor but this can be enhanced on these medications. Ensuring your diet is meeting nutritional targets and resistance training (no gym required, I promise) are fundamental but overlooked factors. Without addressing these people can find themselves in a worse situation metabolically once they come off the medications.

Work with me to help you get the best out of these medications whilst you take them as well as avoiding the very common weight gain associated with stopping these medications. Do this by ensuring you are in the best place with muscle mass, portion sizes, building new habits and behaviour change strategies.